• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1997 April; 87(4): 574–579.
PMCID: PMC1380835

The role of diabetes mellitus in the higher prevalence of tuberculosis among Hispanics.


OBJECTIVES: This research studied the relative contribution of diabetes mellitus to the increased prevalence of tuberculosis in Hispanics. METHODS: A case-control study was conducted involving all 5290 discharges from civilian hospitals in California during 1991 who had a diagnosis of tuberculosis, and 37,366 control subjects who had a primary discharge diagnosis of deep venous thrombosis, pulmonary embolism, or acute appendicitis. Risk of tuberculosis was estimated as the odds ratio (OR) across race/ethnicity, with adjustment for other factors. RESULTS: Diabetes mellitus was found to be an independent risk factor for tuberculosis. The association of diabetes and tuberculosis was higher among Hispanics (adjusted OR [ORadj] = 2.95: 95% confidence interval [CI] = 2.61, 3.33) than among non-Hispanic Whites (ORadj = 1.31: 95% CI = 1.19. 1.45): among non-Hispanic Blacks, diabetes was not found to be associated with tuberculosis (ORadj = 0.93: 95% CI = 0.78, 1.09). Among Hispanics aged 25 to 54, the estimated risk of tuberculosis attributable to diabetes (25.2%) was equivalent to that attributable to HIV infection (25.5%). CONCLUSIONS: Diabetes mellitus remains a significant risk factor for tuberculosis in the United States. The association is especially notable in middle-aged Hispanics.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cantwell MF, Snider DE, Jr, Cauthen GM, Onorato IM. Epidemiology of tuberculosis in the United States, 1985 through 1992. JAMA. 1994 Aug 17;272(7):535–539. [PubMed]
  • Rieder HL, Cauthen GM, Comstock GW, Snider DE., Jr Epidemiology of tuberculosis in the United States. Epidemiol Rev. 1989;11:79–98. [PubMed]
  • SILWER H, OSCARSSON PN. Incidence and coincidence of diabetes mellitus and pulmonary tuberculosis in a Swedish county. Acta Med Scand Suppl. 1958;335:1–48. [PubMed]
  • Flegal KM, Ezzati TM, Harris MI, Haynes SG, Juarez RZ, Knowler WC, Perez-Stable EJ, Stern MP. Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982-1984. Diabetes Care. 1991 Jul;14(7):628–638. [PubMed]
  • Jones EW, Mitchell JR. Venous thrombosis in diabetes mellitus. Diabetologia. 1983 Dec;25(6):502–505. [PubMed]
  • Hernández García P, Martínez Cruz F, Cayuelas Martínez T. PPD y quimioprofilaxis en la diabetes mellitus. Aten Primaria. 1992 Feb;9(2):106–108. [PubMed]
  • Mori MA, Leonardson G, Welty TK. The benefits of isoniazid chemoprophylaxis and risk factors for tuberculosis among Oglala Sioux Indians. Arch Intern Med. 1992 Mar;152(3):547–550. [PubMed]
  • BOUCOT KR, DILLON ES, COOPER DA, MEIER P, RICHARDSON R. Tuberculosis among diabetics: the Philadelphia survey. Am Rev Tuberc. 1952 Jan;65(12):1–50. [PubMed]
  • Harris MI. Epidemiological correlates of NIDDM in Hispanics, whites, and blacks in the U.S. population. Diabetes Care. 1991 Jul;14(7):639–648. [PubMed]
  • Levin VR. Tuberculosis incidence and the seroprevalence of HIV infection in the United States. Am J Prev Med. 1991 Nov-Dec;7(6):422–424. [PubMed]
  • Kelen GD, Fritz S, Qaqish B, Brookmeyer R, Baker JL, Kline RL, Cuddy RM, Goessel TK, Floccare D, Williams KA, et al. Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med. 1988 Jun 23;318(25):1645–1650. [PubMed]
  • Greenberg BL, Weisfuse IB, Makki H, Adler J, el-Sadr W, Clarke L, Gainey S, Alford T, McFarlane K, Thomas PA. HIV-1 seroprevalence in chest clinic and hospital tuberculosis patients in New York City, 1989-1991. AIDS. 1994 Jul;8(7):957–962. [PubMed]
  • Connell FA, Diehr P, Hart LG. The use of large data bases in health care studies. Annu Rev Public Health. 1987;8:51–74. [PubMed]
  • Jollis JG, Ancukiewicz M, DeLong ER, Pryor DB, Muhlbaier LH, Mark DB. Discordance of databases designed for claims payment versus clinical information systems. Implications for outcomes research. Ann Intern Med. 1993 Oct 15;119(8):844–850. [PubMed]
  • Romano PS, Mark DH. Bias in the coding of hospital discharge data and its implications for quality assessment. Med Care. 1994 Jan;32(1):81–90. [PubMed]
  • Blustein J. The reliability of racial classifications in hospital discharge abstract data. Am J Public Health. 1994 Jun;84(6):1018–1021. [PMC free article] [PubMed]
  • Braveman P, Schaaf VM, Egerter S, Bennett T, Schecter W. Insurance-related differences in the risk of ruptured appendix. N Engl J Med. 1994 Aug 18;331(7):444–449. [PubMed]
  • Krieger N. Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology. Am J Public Health. 1992 May;82(5):703–710. [PMC free article] [PubMed]
  • Susser M. The logic in ecological: I. The logic of analysis. Am J Public Health. 1994 May;84(5):825–829. [PMC free article] [PubMed]
  • Olmos P, Donoso J, Rojas N, Landeros P, Schurmann R, Retamal G, Meza M, Martinez C. Tuberculosis y diabetes mellitus: estudio longitudinal-retrospectivo en un hospital docente. Rev Med Chil. 1989 Sep;117(9):979–983. [PubMed]
  • Savagnone E. Studio multicentrico sul rischio infettivo del diabetico. Nota I. Correlazione tra alterato metabolismo glicidico e cutireattività al Multitest IMC. Minerva Endocrinol. 1991 Jul-Sep;16(3):119–125. [PubMed]
  • McAnulty JM, Fleming DW, Hawley MA, Baron RC. Missed opportunities for tuberculosis prevention. Arch Intern Med. 1995 Apr 10;155(7):713–716. [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...